Spinal Tap

[anita]

Still pretty new to Sjogren's World.  I'd like to hear some feedback about Spinal Taps.  I have neurological manifestations of Sjogren's...strokes from antiphospholipid syndrome, severe autonomic dysfunction to include gastro paresis (only 4% empty test), neurally mediated hypotension, Atrial tachycardia (yet a pacemaker for the bradycardia)...and the list goes on. 

My question is whether spinal taps always show inflammation with neurological complications?  Logic tells me that inflammation (what the doctor says he's looking for) in the brain is like meningitis.  I got aseptic meningitis from the IVIG treatment a few years ago and the result on spinal tap was increase in white cells (over 700).  What is the marker on the spinal tap for general inflammation of the brain itself?  Any know?  Is it the same white cells?

Any one have neurological complications of Sjogren's that had a spinal tap...looking for inflammation?  I've had 7 spinal taps over the years(long before they diagnosed the sjogren's), so I know what to expect with the test itself...I'm looking for info on the results.  How good is this test for this purpose, etc?

Thanks for your help,

Anita

[Joe S.]

If you are talking of a mylogram I  would not recommend it. I had one that paralyzed me from the waist down. I did a lot of work to learn to walk with my breathing. I have seen many that never learned to walk again.

[Epson]

I think Joe pretty much answered that question.  I thought it was a movie about a rock band.

[fluffiebunnie]

I think Joe pretty much answered that question.  I thought it was a movie about a rock band.

[Joe S.]

can they do it with an MRI instead?

[Linda196]

There is a difference between spinal tap (or lumbar puncture) for the purpose of obtaining fluid samples and measuring intrathecal (inside the spinal canal) pressure; and a myelogram. A myelogram includes the injection of contrast medium into the spinal canal for taking enhanced images of the spinal canal, either by x-ray, MRI, or other imaging technique. This is much the same as having a spinal or epidural anaesthetic, as there is some amount of material (drug, anaesthetic or contrast) injected into the closed space of the spinal canal.

A properly done tap, with no injection of any drug or contrast, should be below the level of the last branch of nerves from the spinal cord, and for that reason shouldn't interfer with any nerve function, either sensory or motor. For some people with very high intrathecal pressures, the sudden reduction can cause problems, same thing if there is bleeding as a result of the tap. In most cases it's the injection of drug, anaesthetic or contrast that causes problems.

Imaging shows any changes in structure or spacing, but a tap is necessary to obtain cerebrospinal fluid and measure pressure.

[anita]

HI everyone,

This is not a myelogram...it's a spinal tap.  I'm not worried about the procedure, as I have had seven of them over the years.  MRI is not possible due to pacemaker. 

I'm interested in whether others have had a spinal tap (or LP) for diagnostic purposes of neurological complications of Sjogren's.  He's looking for inflammation in the brain causing the severe autonomic dysfunction and possible myelitis...all he said can be from the Sjogren's.

Thanks,

Anita

[Crabcakes]

I will never allow a lumbar puncture. Never. They thought I once had meningitis, and wanted an LP. I refused and said to treat me as if I DID have meningitis. They did and here I am today. I have assisted at many LPs and swore I would never have one myself. Besides, I am a baby when it comes to pain.

[Scottietottie]

Hi - I've had a spinal tap and I didn't find it too bad. This was way before the SjS dx and they were looking for MS, which was ruled out. I now believe it was probably SjS but I have no way of proving it. Once MS was ruled out I was basically told I was a hypochondriac. (NOT!)

The only difficulty they had with the spinal tap was they said my fluid was a bit 'sticky' so hard to get it to flow. They said that was because I was old. I was about 38 at the time!      I wonder if it was a sign of dryness to come?

A lumbar puncture would rule out MS anyway.

Take care - Scottie 

[wordnerd]

I had a spinal tap when I spontaneously stopped being able to move my legs (which we now know is from my CNS involvement - mild brain inflammation).  The tap was fine except I had VERY high pressure for some reason and draining the fluid down to a normal pressure made me feel awful and gave me the worst migraine of my life.  No one has successfully figured out why my pressure was sooo high.  Any thoughts?